GENERIC NAME: FLUMAZENIL Brand name: ROMAZICON Classifications: Benzodiazepine Antagonist

DOSE & ROUTES: 0.2 mg IV over 15-30 sec Parenteral: 2 ml IV given over 15 seconds Oral : none

Therapeutic Action: Flumazenil, an imidazobenzodiazepine derivative, antagonizes the actions of benzodiazepines on the central nervous system. Flumazenil competitively inhibits the activity at the benzodiazepine recognition site on the GABA/benzodiazepine receptor complex. Flumazenil is a weak partial agonist in some animal models of activity, but has little or no agonist activity in man. Indications: Reversing drowsiness, sedation, and other effects caused by benzodiazepines. Adverse effects: Nausea, vomiting, palpitations, sweating, flushing, dry mouth, tremors, insomnia, dyspnea, hyperventilation, blurred vision, headache, pain at injection site Nursing Responsibilities: Observe 15 rights in drug administration. Assess for other contraindications. Keep diphenhydramine injection readily available in case extrapyramidal reactions occur (50 mg IM). Have phentolamine readily available in case of hypertensive crisis.

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Monitor BP carefully dring IV administration. Give direct IV doses slowly over 15 to 30 seconds Dispose of used materials properly. Educate patient about side effects. Instruct to report signs of side effects Instruct patient to take drug exactly as prescribed. Instruct not to use alcohol and non prescription drugs for 1-24 hours Note evidence of sedative and benzodiazepine dependence Do proper documentation

Assessment: Assess evidence of increased ICP, note history of seizure or panic disorder, note evidence of sedative and benzodiazepine dependence. Intervention: Must individualize dosage. Give only smallest amount effective. Give through freely running IV infusion into large vein to minimize pain at injection site. Health teaching: Instruct to avoid alcohol and nonprescription drugs for 1-24 hours